臺灣博碩士論文加值系統

魚油雖然已經被廣泛用作心血管的保健，但是對於乾眼症的症狀
改善功能，目前的文獻報告並沒有一致性。因此本研究大幅度修改魚
油配方，看是否可以改善乾眼症狀。給予24 位自願受試者每日早晚
各一顆魚油配方，成份包含有濃縮魚油504 毫克(20% EPA、50%DHA)。
受試者於受試前和連續食用魚油配方三週後，檢測其乾眼症狀，包含
淚液試紙測試、淚液膜破裂時間、結膜紅腫程度、和淚液滲透壓。同
時測試淚液中的鈉離子、鉀離子、氯離子、澱粉酵素、三酸甘油脂等
淚液生化值，並分析不同性別受試者是否有不同的乾眼症狀改善效
果。結果顯示: 1.短期內攝食富含omega-3 必需脂肪酸魚油，可能對
乾眼症提供部份症狀之緩解。2. 隨著攝食魚油配方，淚液滲透壓到
第三週上升，因此未必能直接推論到長期的效應。3. 淚液滲透壓在
淚液中包含鈉離子、鉀離子、氯離子、與三酸甘油脂。4. 實驗結果
支持以淚液滲透壓當作較好的乾眼症狀診斷方法。5. 推論在攝食
富含omega-3 必需脂肪酸後，眼睛有種未知的平衡系統，用以維持淚
液滲透壓的恆定性。6. 淚液生理男女有別，特別是在淚液膜破裂時
間上。本研究提供短期攝食魚油的功效數據，對後續研究提供良好的
基礎資訊。

Fish oil has been used extensively for cardiovascular protection,
whereas its use for dry eye symptom alleviation is not
well-documented with consensus. This study used an improved
formula and recruited 24 volunteers to take twice daily fish oil
capsules containing 540 mg(20% EPA、50%DHA) for 3 weeks. After
fish oil intake, the volunteers were examined for dry eye symptoms,
including TBUT, Schirmer test, Bulbar Redness, and tear osmolarity,
along with biochemical tear constituents of K, Cl, K, amylase, and TG.
The data were used for comparison between groups of either gender
or difference level of alleviations. The results showed that 1.
Short-term fish oil intake may alleviate dry eye symptoms. 2. Tear
osmolarity elevated at week3 after the intake, suggesting lng term
change may be possible. 3. Tear osmolarity factors included K, Cl, K,
and TG. 4. Tear osmolarity may be used as a better criterion for dry
eye diagnosis. 5. Fish oil intake may trigger an unknown system to
improve teat osmolarity homeostasis. 6. Gender-specific difference of
tear characteristics exist. To conclude, this study provided the
baselines data for further investigation on the use of fish oil for dry
eye alleviation.

簽名頁……………………………………………………………………i
誌謝…………………………………………………………………….ii
摘要……………………………………………………………………iii
Abstract……………………………………………………………….iv
目錄……………………………………………………………………..v
圖目錄…………………………………………………………………ix
表目錄…………………………………………………………………xi
第一章 前言…………………………………………………………….1
1.1 淚液來源分泌與淚液層介紹………………………………………1
1.1.1 淚液來源與分泌…………………………………………………1
1.1.2 淚液層……………………………………………………………3
1.2 乾眼症………………………………………………………………4
1.2.1 乾眼症的定義與分類…………………………………………….4
1.2.2 乾眼症的罹患率與風險因子……………………………………14
1.2.3 乾眼症的實驗診斷………………………………………………16
1.2.4 乾眼症的藥物治療與處置………………………………………17
1.2.4.1 乾眼症的治療…………………………………………………17
1.3 魚油…………………………………………………………………21
1.3.1 魚油的來源和成份配方…………………………………………21
1.3.2 魚油對全身性代謝的效應………………………………………24
1.3.3 魚油對乾眼的效應………………………………………………26
1.3.3.1 攝食omega -6 對乾眼的效應…………………………………26
1.3.3.2 攝食omega-3 對乾眼的效應…………………………………28
1.3.3.3 攝食omega-3 和omega-6 對乾眼的共伴效應………………29
1.4 研究動機與研究問題………………………………………………30
1.4.1 研究動機…………………………………………………………30
1.4.2 本研究要解答的問題……………………………………………31
第二章 材料與方法……………………………………………………34
2.1 魚油的來源與配方…………………………………………………34
2.2 食用方式……………………………………………………………34
2.3 受試者召募…………………………………………………………34
2.4 實驗設計與流程……………………………………………………35
2.5 樣本收集與量測方法………………………………………………36
2.5.1 淚液收集…………………………………………………………36
2.5.2 淚液滲透壓測量與相對淚液滲透壓變化值計算………………36
2.5.3 球結膜充血程度評估……………………………………………38
2.5.4 淚液試紙分析……………………………………………………40
2.5.5 淚液膜破裂時間分析(Tear film Break-Up Time; TBUT)……41
2.5.6 淚液生化值檢測…………………………………………………42
第三章 結果……………………………………………………………42
3.1 受試者基本資料……………………………………………………42
3.2 攝食魚油前後受試者雙眼的乾眼測試和相對淚液滲透壓平均值的
變化…………………………………………………………………43
3.3 攝食魚油前後受試者的乾眼測試和相對淚液滲透壓雙眼差異平均
值的變化……………………………………………………………44
3.4 以單隻眼睛為單位分析攝食魚油前後受試者雙眼的乾眼測試和相
對淚液滲透壓變化…………………………………………………46
3.5 攝食魚油前後受試者雙眼的乾眼測試和相對淚液滲透壓平均值的
分佈變化……………………………………………………………47
3.6 攝食魚油前後受試者雙眼的結膜紅腫程度的分佈變化…………50
3.7 攝食魚油前後雙眼的淚液試紙測試值差小於平均值族群的結膜
紅腫程度變化………………………………………………………51
3.8 攝食魚油前後受試者雙眼的乾眼測試和相對淚液滲透壓差異的分
佈情形………………………………………………………………52
3.9 攝食魚油前相對淚液滲透壓和其它乾眼測試值的相關性分析…53
3.10 攝食魚油前後相對淚液滲透壓和其它乾眼測試差值的相關性分
析…………………………………………………………………54
3.11 攝食魚油前後相對淚液滲透壓和其它乾眼測試差值與攝食魚油
後測試值的相關性分析…………………………………………55
3.12 以雙眼測試平均值分佈圖分析攝食魚油對於改善乾眼症狀的性
別差異……………………………………………………………56
3.13 以雙眼測試差值分佈圖分析攝食魚油對於改善乾眼症狀的性別
差異………………………………………………………………57
3.14 攝食魚油後淚液生化值與乾眼症狀檢測值的相關性…………58
第四章 討論……………………………………………………………60
第五章 結論與建議……………………………………………………64
參考文獻………………………………………………………………65

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